The Role We Can Play in the Reform of the Nation’s Health Care Workforce

Justine Strand, DrPH, PA-C
President

Fifteen years after the last serious attempt at providing health care coverage for every American, with the historic inauguration of President Obama and a global economy in crisis, health care reform seems achievable for the first time in many years. This may at first appear counterintuitive since U.S. health care spending as a percentage of GDP is the highest in the world yet has health outcomes that are not the best in the world. However, a unique aspect of health insurance in America is that it is tied to employment, and with more Americans from all socioeconomic strata losing their jobs, pressure for reform will mount. Individuals and families are being priced out of the market, and businesses can no longer afford the ever increasing costs of insuring their employees.

Health care reform will not be possible, however, without an adequate health care workforce. The recent implementation of universal coverage in Massachusetts has shown that we don’t have enough health care professionals to meet the needs of a state, let alone those of an entire nation. There is wide recognition of an anticipated shortage of physicians and a growing realization among health workforce experts that we are not producing a sufficient number of PAs. PAs are the pluripotent health care workforce stem cells: we can be deployed rapidly to areas of need, be it primary care or subspecialties. As PA educators, we are the leaders influencing the PA workforce pipeline. The health care system must change, and the PA profession must be part of that change.

PAEA is mobilizing to ensure that our members are up to speed on the movement toward health care reform. We must be knowledgeable and aware, and we must provide up to the minute information to our students to prepare them for their roles as future change agents. To that end, PAEA, in collaboration with AAPA’s federal affairs staff, will be providing quarterly Webinars to inform PAEA members of evolving health care reform efforts over the course of the next year. The first of these is scheduled for February 24, and I hope you received the invitation from PAEA staff just the other day to join us. We hope you will tune in for this and future updates from our nation’s capital!

Your PAEA board is fulfilling the role for which you elected us, responding to requests for input as change ramps up in Washington. We recently provided the following set of PAEA draft health care reform principles to the Department of Health and Human Services:

• PAEA supports reform efforts that promote production of a workforce adequate to meet the current and projected health care needs of the nation. The workforce should include a variety of qualified health care professionals working together in physician-directed teams.
• PAEA supports the creation of new funding streams and the expansion of existing ones for the education of health professionals. We support an equitable, fair, and efficient process for distributing those funds across the health professions. Funding reform should include expansion of loan opportunities for students as well as loan repayment (forgiveness) programs for PA graduates who provide primary care services and medical services to the underserved. Loan repayment programs should also be expanded to include PA educators.
• PAEA favors policy and regulatory actions that ensure an adequate supply of clinical training sites and that those sites remain affordable for the educational institutions that utilize them. Incentives are needed to promote site development.
• PAEA supports policies that promote development of a diverse health care workforce that will meet the needs of and reflect the patient population it serves.
• PAEA supports the increased utilization of technology, including electronic medical records, to improve efficiencies within the health care system and to support the safety of patients served by it.

As President Obama stated in his inaugural address, “Starting today, we must pick ourselves up, dust ourselves off, and begin again the work of remaking America.” Well-informed PA educators can and must make a vital contribution to reforming health care in our nation.